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A case of Lymphoplasmacyte-rich meningioma mimicking pachymeningitis

Yue Zhang1, Xiang Zhang1, Abhijeet Kumar Bhekharee2

  • 1Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.

BMC Neurology
|July 29, 2022
PubMed
Abstract

Insights

Lymphoplasmacyte-rich meningioma (LPRM) can rarely present as a flat, carpet-like dural lesion mimicking pachymeningitis. Long-term MRI surveillance is crucial for detecting LPRM growth.

Area of Science:

  • Neuropathology
  • Neuroimaging
  • Oncology

Background:

  • Lymphoplasmacyte-rich meningioma (LPRM) is a rare meningioma subtype.
  • LPRM characteristically features significant lymphoplasmacytic infiltration.
  • The presentation of LPRM with a flat, pachymeningitis-mimicking growth pattern is exceptionally uncommon.

Observation:

  • A 55-year-old female presented with headaches and seizures.
  • Initial MRI revealed a stable, carpet-like enhancing dural lesion over 4 years, initially diagnosed as pachymeningitis.
  • Subsequent MRI demonstrated significant lesion growth, prompting surgical resection.

Findings:

  • Pathological examination of the resected lesion confirmed Lymphoplasmacyte-rich meningioma (LPRM).
  • This case highlights an unusual presentation of LPRM with a diffuse, flat growth pattern.

Implications:

  • LPRM should be considered in the differential diagnosis of dural lesions with atypical growth patterns.
  • Extended radiological follow-up is essential for patients with suspected pachymeningitis to monitor for potential neoplastic transformation or growth.
  • This case underscores the importance of histopathological confirmation for persistent or evolving dural lesions.
Keywords:
En plaque meningiomaLymphoplasmacyte-rich meningiomaPachymeningitis

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